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*UARTERPY INVENTORY POIRTI"NG <br />Facility Name: <br />Facility Address: Q L IL I <br />City: /- J I <br />,I <br />County: <br />State. <br />hese were inventory <br />2r'ex'ceeded the allowable <br />quarter. <br />MUM M. <br />at <br />variations th <br />I hereby certify that all product level variations <br />limits for this for the above mentioned facility were <br />within allowable limits for this quarter. <br />LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS <br />THAT EXCEED THE ALLOWABLE LIMITS. <br />Explanation <br />at <br />variations th <br />I hereby certify that all product level variations <br />limits for this for the above mentioned facility were <br />within allowable limits for this quarter. <br />LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS <br />THAT EXCEED THE ALLOWABLE LIMITS. <br />OUT OF TOLERANCE <br />INVESTIGATIVE STEPS <br />Step I Review Records . <br />Step 2 New reconciliation <br />performed. <br />Step 3 Shell Oil notified. <br />Step 4 Records review from <br />the last stable <br />situation. <br />Step 5 Physical facilities <br />inspected for leaks. <br />Step 6 Dispenser meters <br />calibrated. <br />Step 7 Piping hydrostatically <br />tested. <br />Step 8 Underground storage <br />tanks precision tested. <br />Step 9 Additional investigation <br />as required by Shell <br />or the local agency. <br />This quarterly summary report <br />shall be submitted within 15 days <br />after the end of each quarter. Check <br />the quarter you are submitting <br />Quarter 1 — January thru March <br />Submit by April 15 <br />El Quarter 2 — April thru June <br />Submit by July 15 <br />96/uarter 3 — July thru September <br />Submit by October 15 <br />El Quarter 4 — October th ru December <br />Submit by January 15 <br />Send to (Local Agency)': S4 A) 9",&U, A2 .4 <br />DEALER SIGNATURE DATE <br />Explanation <br />EWE, <br />IMIMMI <br />JI <br />OUT OF TOLERANCE <br />INVESTIGATIVE STEPS <br />Step I Review Records . <br />Step 2 New reconciliation <br />performed. <br />Step 3 Shell Oil notified. <br />Step 4 Records review from <br />the last stable <br />situation. <br />Step 5 Physical facilities <br />inspected for leaks. <br />Step 6 Dispenser meters <br />calibrated. <br />Step 7 Piping hydrostatically <br />tested. <br />Step 8 Underground storage <br />tanks precision tested. <br />Step 9 Additional investigation <br />as required by Shell <br />or the local agency. <br />This quarterly summary report <br />shall be submitted within 15 days <br />after the end of each quarter. Check <br />the quarter you are submitting <br />Quarter 1 — January thru March <br />Submit by April 15 <br />El Quarter 2 — April thru June <br />Submit by July 15 <br />96/uarter 3 — July thru September <br />Submit by October 15 <br />El Quarter 4 — October th ru December <br />Submit by January 15 <br />Send to (Local Agency)': S4 A) 9",&U, A2 .4 <br />DEALER SIGNATURE DATE <br />